In Sri Lanka’s North Central Province more than 23,500 people have died of Chronic Kidney Disease of undetermined causes (CKDnT), earning it the moniker, “the hot zone.” In many communities 15% of the population is affected, mainly farmers working in the sun, using agricultural chemicals. While state funded dialysis centers care for hundreds of patients, many of these rural, affected farmers prefer their traditional Sinhala medicine system, where a combination of dietary and spiritual therapy promises to cure them. Local researchers are now joining with international investigators, but some feel their research into chemical related causes are being blocked by business interests.

In the Hot Zone follows two men in their fight against CKDnT. Terrence, a former lab technician and farmer, is a tireless activist, racing to organize data collection and community outreach programs in order to prevent the onset of the disease affecting his fellow farmers. H.B., who comes from a long line of rice farmers, has put his hope in the Sinhala medicine tradition after he feels that Western Medicine failed in curing him and waits to go home to his family.

While the causes of CKDnT here need to be more thoroughly studied, all actors agree that the collateral damage of the disease is only beginning to be felt. “This is not only a health problem, this is a problem of our civilization, this is a problem of our society, this is a problem of our economy.” says Dr. Jayasumana. As doctors and activists work towards prevention in the affected communities, patients pray for healing.

A film by Tom Laffay
Cover photo by Ed Kashi